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Speaker 1: President Biden announcing for the first time ever, Medicare will

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Speaker 1: begin negotiating drug prices with manufacturers, targeting ten major medications

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Speaker 1: that treat everything from diabetes to blood cloths to cancer.

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Speaker 1: The President says it will mean lower healthcare costs for

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Speaker 1: millions of Americans. As many as nine million seniors take

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Speaker 1: at least one of the drugs on the list, some

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Speaker 1: paying up to six five hundred dollars out of pocket

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Speaker 1: each year. Seniors will see those savings kick in in about.

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Speaker 2: Two and a half years.

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Speaker 1: The prices have to first be negotiated with those drug companies,

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Speaker 1: and some of them are already trying to block this

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Speaker 1: program in court. But still the White House says they're

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Speaker 1: confident they will win and that the list of drugs

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Speaker 1: announced today is just the beginning.

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Speaker 2: So the question I have any time I hear a

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Speaker 2: story like that is how true? Is it? Is it

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Speaker 2: going to matter to me or just other people? So

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Speaker 2: we thought we'd talked to an expert.

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Speaker 3: Yeah, indeed, and that two and a half years from

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Speaker 3: now thing m Yeah, Craig got Walls. Craig, the healthcare guru,

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Speaker 3: joins us. He's an attorney, lawn benefit consultant, with benefit Revolution. Craig, Well,

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Speaker 3: how are you, sir?

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Speaker 4: I'm well, how are you, gentlemen? Oh?

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Speaker 3: Terrific? Thank you. So what did you make of this?

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Speaker 3: How significant is it?

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Speaker 4: It's a good deal, man. It's you know, when your

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Speaker 4: dog comes to you after ignoring you for weeks and

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Speaker 4: weeks and weeks, you don't spank it, right, You reward

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Speaker 4: the dog for coming to you. And so this is

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Speaker 4: this is a move in the right direction. Now, the

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Speaker 4: analogy I would give you, guys is we're in a

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Speaker 4: canoe in the middle of a lake. It's rocking and rolling,

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Speaker 4: and we've got a big leak and the water's coming

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Speaker 4: in rapidly. In our right cup, we have a red

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Speaker 4: solo cup. That's the Trump Trump transparency regulations. In our

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Speaker 4: left cup, we now have a dixie cup and we're

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Speaker 4: bailing that canoe. And this dixie cup is this drug

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Speaker 4: deal only because it's just ten drugs and it's two

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Speaker 4: and a half years away. I totally applaud the move.

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Speaker 4: We need way more of this, But how about all

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Speaker 4: the drugs starting tomorrow? Right? I mean, this is just

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Speaker 4: a travesty. We're overpaying. We pay three times what other

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Speaker 4: countries pay for these same darn drugs and it's just

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Speaker 4: because it's been all mobbed up for twenty plus years

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Speaker 4: and can't negotiate with with the drug companies.

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Speaker 3: Well, you partially answered my next question. But why such

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Speaker 3: an incremental move, do you think?

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Speaker 4: Well, because, uh, because healthcare is the number one lobby

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Speaker 4: in the United States and healthcare is the number one

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Speaker 4: industry in the United States. And it's really bad for

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Speaker 4: reelection if you say, if you say no, or if

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Speaker 4: you try and curtail those people that are paying for

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Speaker 4: your reelection.

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Speaker 2: Oh man, yep. So and okay, before I get to

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Speaker 2: my question, So we're paying three times more than the

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Speaker 2: rest of the world for the same drugs on average.

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Speaker 4: That's actually yes, right.

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Speaker 2: That ain't good.

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Speaker 4: So nope.

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Speaker 2: So the news report there mentioned the drug companies are

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Speaker 2: trying to you know, they're pushing back, they're trying to

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Speaker 2: come up with a way around it. Do you think

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Speaker 2: in two and a half years they'll figure out a

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Speaker 2: way around it.

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Speaker 4: Well, they're certainly going to try. And there are I

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Speaker 4: counted up yesterday eight lawsuits already filed just on this topic.

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Speaker 4: So every major drug manufacturer is in on it, and

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Speaker 4: they want to stop it. Obviously, because that chokes off

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Speaker 4: their cash cow, don't I don't know if they'll have

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Speaker 4: success this time around, because you know, we're thirty three

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Speaker 4: trillion in debt as a country. We are a bankrupt

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Speaker 4: you know, insurance company effectively with a with a failing military.

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Speaker 4: So I don't see how I don't see how you

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Speaker 4: make the argument that we can't do this. I mean,

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Speaker 4: this one, this one, to me, is a no brainer

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Speaker 4: that overwhelmingly Republicans and Democrats agree on. I mean, I

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Speaker 4: think it's something like seven percent of Republicans agree we

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Speaker 4: should be negotiating these prices, and it's like mid eighties

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Speaker 4: for Democrats. I'll tell you where this became screwy, gentlemen.

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Speaker 4: Was it was something we never did. We never negotiated

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Speaker 4: these prices. Okay, we just accepted whatever bogus off the

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Speaker 4: shelf price the drug companies wanted, and we paid it

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Speaker 4: with Medicare and Medicaid.

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Speaker 3: Which is bizarre, if I might interject, I mean, can

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Speaker 3: you imagine bizarre?

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Speaker 4: Yeah, imagine if we had to go buy cars that way. Well,

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Speaker 4: of course, that's kind of how the government does buy cars.

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Speaker 4: Sticker price for everything. But in two thousand and two,

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Speaker 4: George Bush wrote this into law. He codified it, which

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Speaker 4: didn't really change the modus operendi because we weren't negotiating anyway,

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Speaker 4: but it was again a nod to one of his

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Speaker 4: largest donor classes, Big Pharma. Then this is where it

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Speaker 4: gets fascinating. You had pushback on it because Democrats were

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Speaker 4: against that. Democrats were four price negotiation, and Republicans were

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Speaker 4: against it. And that went all the way up to

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Speaker 4: two thousand and nine. And in two thousand and nine,

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Speaker 4: President Obama realized, there's no way I'm going to get

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Speaker 4: Obamacare passed unless I get the hospitals, the insurance companies,

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Speaker 4: and big pharma on my side. So he gave out

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Speaker 4: little dog treats to each of those industries, and the

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Speaker 4: dog treat he gave to Pharma was, we will, even

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Speaker 4: with Obamacare, we will not negotiate drug prices. And then

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Speaker 4: Obama took money from the healthcare industry, which was something

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Speaker 4: that Democrats didn't buy and large do at that time.

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Speaker 4: But what that did is it opened the floodgates. So

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Speaker 4: now after two thousand and nine, both parties are on

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Speaker 4: the pay life of the massive lobbies associated with healthcare.

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Speaker 4: And that's what's kick this can all the way down

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Speaker 4: the road to twenty twenty three, where finally we got

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Speaker 4: to do something right. The house is on fire and

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Speaker 4: all we've got to fire all We've got the garden hose.

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Speaker 4: So what do we do? We're going to negotiate these

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Speaker 4: ten two and a half years from now. It's really

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Speaker 4: similar to what they did with Obamacare. Wow.

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Speaker 3: I didn't think I could become more cynical through the

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Speaker 3: course of a single segment of the show. But I

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Speaker 3: have you remember when three or four years ago, Craig,

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Speaker 3: you and I were semi obsessive about figuring out where

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Speaker 3: we should move where there is liberty and free markets

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Speaker 3: and that sort of thing.

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Speaker 2: Are you still on that way?

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Speaker 3: Where would you go right now?

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Speaker 2: As an ex pad Portugal?

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Speaker 4: That's my latest one is portable Portugal. I just did

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Speaker 4: a neighbor go there and he's telling me all about it.

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Speaker 4: It sounds fantastic.

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Speaker 3: Wow, Wow, warm Weather beaches, et cetera. Okay, so.

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Speaker 4: Maybe I'm going to say, Jack, I want to tell

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Speaker 4: you guys the story of a drug. I just want

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Speaker 4: to if I can, if I can fit it in here,

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Speaker 4: I want to illustrate this point where you just how

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Speaker 4: corrupt this is. So Aveston and lucentis same drug, same

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Speaker 4: active components made by Genentech, Lucentus came first. The problem

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Speaker 4: is Lucentus is thirty eight times more expensive than Aveston.

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Speaker 4: So Leucentus is used to treat cancer by slowing the

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Speaker 4: growth of blood vessels that feed the tumors. But innovative

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Speaker 4: doctors realized, oh my gosh, we could inject a tiny

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Speaker 4: amount of Aveston into an eyeball in slow macular degeneration.

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Speaker 4: It worked, it was phenomenal, and in so doing they

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Speaker 4: used so little it was only sixty dollars per injection. Okay,

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Speaker 4: So Genentech says, well, we can't have that. We're not

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Speaker 4: making enough money on it. So genen Tech repackages Aveston,

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Speaker 4: rebrands it is Loucentus, sells it for the eye, and

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Speaker 4: charges twenty three hundred dollars per dose, thirty eight times

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Speaker 4: thirty eight times what doctors were paying to do it.

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Speaker 4: Then Genentech comes out and says, and by the way,

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Speaker 4: you can't use Aveston anymore, it's not safe. Honorable ophthalmologist

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Speaker 4: said that's bs we can still use it. And they

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Speaker 4: fought it and they sued in genen tech back down. Now,

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Speaker 4: why would doctors want to prescribe that more expensive drug

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Speaker 4: because they're paid six percent of the cost of the drug.

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Speaker 4: So every doctor that was prescribing Loocentus made one hundred

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Speaker 4: and thirty eight dollars a pop, while every doctor that

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Speaker 4: was still using the avestin was only making a Starbucks Americano. Wow,

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Speaker 4: that's just one drug example, Jens, one drug example that

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Speaker 4: I have followed over the years, and our industry is

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Speaker 4: riddled with them, riddled with them. So when they come

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Speaker 4: out and say it's a big deal to negotiate ten

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Speaker 4: you know what, it's a big deal to negotiate. I'm

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Speaker 4: happy we're doing it, but we need to be negotiating

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Speaker 4: all these prices right now. It's our tax dollars. This

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Speaker 4: is our biggest expense, and we're taking it so lightly

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Speaker 4: in the face of thirty three trillion in debt.

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Speaker 3: Well, and you pile that on top of the discussion

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Speaker 3: we've had several times about how Obamacare has enriched the

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Speaker 3: major insurance companies beyond their wildest dreams. That their stock

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Speaker 3: price has risen seventeen times faster than the S and

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Speaker 3: P five hundred orld, whatever the number is. It is utterly,

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Speaker 3: utterly corrupt.

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Speaker 4: It is. It is. You know what, I've been in

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Speaker 4: this industry for twenty two years, gentlemen, I've never been

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Speaker 4: more cynical. But I'll tell you what, I've also never

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Speaker 4: been more excited and had more fun because we now

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Speaker 4: have tools to fight this. And this is going to

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Speaker 4: give us tools to fight it because every drug they

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Speaker 4: start to negotiate, the private market will seize upon and

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Speaker 4: we'll be able to ride those coattails and negotiate lower

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Speaker 4: prices for themselves as well. So it's a dixie cup

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Speaker 4: to a flooding canoe. But at least I got a

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Speaker 4: dixie cup in one hand and a Solo cup in

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Speaker 4: the other, so we're using them.

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Speaker 2: I don't know if my question is like a completely

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Speaker 2: different topic, but like I always just picked the pharmacy

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Speaker 2: it was closest to my house or my hospital. That's

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Speaker 2: the way I always did it because it just seemed easier.

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Speaker 2: But then, so I was going to buy a drug

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Speaker 2: at I won't mention the name, but I was going

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Speaker 2: to buy a drug at one of your popular pharmacies

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Speaker 2: and they didn't have it. It was a lot, and

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Speaker 2: the pharmacists actually said, can I talk to you for

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Speaker 2: a second, said, and said, I shouldn't say this, but

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Speaker 2: if he over to Costco, it's going to be like

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Speaker 2: ten bucks. Ah, I said, really, you said yeah? So

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Speaker 2: then I saw I went to Costco and it was

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Speaker 2: ten bucks as opposed to as like ninety bucks. There.

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Speaker 2: What why?

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Speaker 4: How?

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Speaker 2: What is that? Is that just purely in the private

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Speaker 2: industry between like CBS, Walgreens, Rite aiding Costco? Or is

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Speaker 2: that part of the whole thing.

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Speaker 4: Yeah, roughly seventy five percent of the drug market is

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Speaker 4: controlled by three PBMs prescription benefit managers, and Jack, what

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Speaker 4: you just said is true. It happens all the time.

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Speaker 4: You know. One of the things we're doing with smaller employers,

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Speaker 4: with self funded employers is we're steering them to the

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Speaker 4: lower cost pharmacies. We have an app built into their phone.

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Speaker 4: When they get their prescription. We tell them where's the

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Speaker 4: cheapest place within ten miles at their home to get

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Speaker 4: that drug, and we show them the price different. Yeah.

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Speaker 2: I get it, and it's tools, but it can be worthwhile.

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Speaker 2: But like now, instead of just always going to the

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Speaker 2: place closest to my house, which I've done my whole life,

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Speaker 2: I've got like four different pharmacies, some of them really

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Speaker 2: a long way away, but it's a much cheaper way

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Speaker 2: to get the drugs.

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Speaker 3: Yeah, everybody has to become a health care bargain hobbyist. Yes, wow, great, Yeah,

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Speaker 3: Craig gotwaals, Craig the healthcare guru. Really interesting stuff, Craig.

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Speaker 3: It's you know, it's appalling to me how few Americans

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Speaker 3: will hear a description as simple, lucid, and undeniable as

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Speaker 3: our folks just heard. Does nobody have an interest in

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Speaker 3: reporting this stuff? It affects everybody all the time.

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Speaker 4: Well, one that was conspiratorial minded might argue that when

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Speaker 4: your number one advertiser is this industry, it's really hard

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Speaker 4: to have people on that talk badly about it.

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Speaker 3: It's a good point. Wrong number, a new phone? Who

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Speaker 3: do is lose our number? Craig, go away, Craig gotwalls. Craig,

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Speaker 3: It's always a pleasure. We have a link at Armstrong

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Speaker 3: in getty dot com if you want to get in

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Speaker 3: touch with Craig and learn more about benefits and drug

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Speaker 3: prices and that sort of thing. Always good to talk to.

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Speaker 2: You, aboud.

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Speaker 4: Thanks, gentlemen, have them hit my substat Okay, cool?

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Speaker 3: Yeah, sure hit is Substack. We'll have a link to

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Speaker 3: that too, Armstrong and getdy on. I'm sorry Armstrong geddy

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Speaker 3: dot com.

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Speaker 2: I don't know if I. He says, it's mostly good news,

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Speaker 2: so that's it's going the right direction on that particular thing.

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Speaker 2: But I still came away with a bad feeling. I

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Speaker 2: guess because the whole the healthcare industry being the biggest

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Speaker 2: industry in the country and the biggest lobbyist in the country.

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Speaker 2: That's frustrating.

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Speaker 3: Yes, and it does have a feel of, you know,

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Speaker 3: at your job, they don't let you take your lunch breaks.

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Speaker 3: They punch you in the face regularly at work, and

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Speaker 3: they've stolen your car five times, and they've announced, hey,

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Speaker 3: we're gonna let you take your lunch break now.

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Speaker 2: I meant